Sleep paralysis in narcolepsy: More than just a motor dissociative phenomenon?

Michele Terzaghi, Pietro Luca Ratti, Francesco Manni, Raffaele Manni

Research output: Contribution to journalArticlepeer-review

Abstract

Sleep paralyses are viewed as pure motor phenomena featured by a dissociated state in which REM-related muscle atonia coexists with a wakefulness state of full consciousness. We present a 59-year-old man diagnosed with narcolepsy experiencing sleep paralysis, who failed to establish the boundaries between real experience and dream mentation during the paralysis: the patient's recall was indeed featured by uncertainty between real/unreal and awaken/dreaming. Hereby, we suggest that sleep paralysis may represent a more complex condition encompassing a dissociated state of mind together with the dissociative motor component. Neurophysiological data (spectral EEG analysis corroborated by cross-correlation analysis) reinforce the idea that the patient was in an intermediate state of mind between wake and REM sleep during the paralysis. The persistence of local impaired activity proper of REM sleep in cortical circuits necessary for self-reflective awareness and insight, in conflict with wakefulness-related activation of the remaining brain areas, could account for disrupted processing of afferent inputs in our patient, representing the underlying pathophysiologic substrate for patient's failure to establish the boundaries between real experience and dream mentation.

Original languageEnglish
Pages (from-to)169-172
Number of pages4
JournalNeurological Sciences
Volume33
Issue number1
DOIs
Publication statusPublished - Feb 2012

Keywords

  • Dissociated state
  • Narcolepsy
  • REM sleep
  • Sleep paralysis
  • Spectral analysis

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Dermatology

Fingerprint

Dive into the research topics of 'Sleep paralysis in narcolepsy: More than just a motor dissociative phenomenon?'. Together they form a unique fingerprint.

Cite this